Introduction 

Brief Profile of the Organization

HOPE 2020 is a non-governmental, non-political, non-religious local NGO established in 2004 with the general objectives of improving the life of the rural communities through providing potable water, hygiene and sanitation services; introducing modern irrigation systems; increasing the rural community’s awareness on HIV/AIDS prevention; providing the necessary care and support for orphans and vulnerable children; reducing gender inequality through women empowerments and contributing its part to environmental protection.

It is a legally registered association by the Federal Democratic Republic of Ethiopia Ministry Of Justice with registration certificate number 1865 and is licensed to operate as an NGO in its particular areas of interest and intervention meeting all the legal requirements. It has also an operational agreement with Federal and Oromia Food Security Disaster Prevention and Preparedness Commission.

In line with its memorandum of association and relevant laws of the country, the association has a Board of Directors, a governing body that provides leadership and direction on strategic issues   such as strategic and annual plans, annual budget, salary schemes, and exercise control to ensure that the association is operating within and inline with the laws of the country and its own constitution. It has a General Manager responsible for giving over all directions for the day-to-day operations of the association inline with the directions and decisions of the Board of Directors.

Currently HOPE 2020 implementing water supply, sanitation, hygiene promotion, HIV/AIDS prevention, care and support, orphans care and support and other projects in Saden Soddo, Woliso and Tole weredas of South West Shoa zone of Oromia National Regional State.

The association’s integrated rural development programs to solve the various socio-economic problems of the rural community attracted international NGOs like Water Aid-Ethiopia, Comitato Internazionale per lo sviluppo dei popoli (CISP-Italian based international NGO) and Water Millennium Alliance (USAID) which are currently working as a partner with the association.

Vision, Mission and Objectives

Vision

HOPE 2020 has a vision to see a health, gender balanced, prosperous and productive society that lice in a clean and fresh environment.

Mission

• Improve the health situation of the rural community by increasing their access to potable water and promoting hygiene education and environmental sanitation
• Fight the spread of HIV/AIDS and its associated problems
• Improve the livelihood of the rural community through introducing modern irrigation practices and by establishing saving and credit schemes
• Increase the rural communities access to basic education and health services
• Create gender-balanced society through women empowerment activities
• Protect the environment through natural resources management and introducing alternative energy sources.

Objective

The general objective of the organization is to alleviate poverty by supporting and stimulating the economic and social growth of the rural communities with priority to children, women and the elderly.

 

Background of the project

Reproductive health implies that the capability to reproduce and the freedom to decide if, when and how often to do so. It is the rights of men and women to be informed and have access to safe effective affordable and acceptable methods of family planning of their choice and the right of access to appropriate health care services that will enable women to go safely through prevention and solving reproductive health problems. It also includes sexual health, the purpose of which is the enhancement of life and personal relations and not merely counseling and care related to reproductive and sexually transmitted diseases (USAID, 2003).

The reproductive health concept recognizes the degree to which individual needs arise not only as a consequence of purely biological circumstances, but also of events that might be more culturally, socially, or ethnically defined. Thus the scope of reproductive health includes concerns over women’s status and the guarantee of human rights. Finally, the concept acknowledges the reproductive health needs of all individuals, including those of men and adolescents (Save the Children, 2004).

Overview of Adolescent Reproductive and Sexual Health

As the information from population reference bureau (PRB), more than a quarter of the world’s population is between the ages of 10 to 24, of these adolescents, the vast majority 86% live in developing countries. Besides this fact, adolescent worldwide lack basic information about their bodies and the power and means to protect themselves and make informed decisions about their lives. They become victims of early arranged marriages; early and unwanted pregnancies and births, sexually transmitted diseases including STDs/AIDS; illegally induced, unsafe abortions; female genital mutilation; sexual violence and exploitation; pregnancy associated morbidity and mortality; school dropout and overall curtailed life options due to early child bearing (Pathfinder international, 2001).

One of the most sensitive issues associated with adolescence is sexuality. They receive inadequate educational guidance and services that help them make the transition to adulthood. Often they are denied complete access to reproductive health information and services. With their limited knowledge about their bodies and their sexuality, they are vulnerable to sexually transmitted diseases and infections including HIV/AIDS, substance abuse, sexual exploitation and violence. Girls are further vulnerable and face higher risks due to their lower educational status and inability to negotiate on issues related to reproductive and sexual health.

Thus, it is not surprising when one encounters these facts:

• One in every ten births world-wide is to teenage  mothers
• One in every six births is to young women aged 15 to 19 in least developing countries.
• Pregnancy before age 18 has many health risks and girls below age 15 are five times more likely to die in pregnancy or childbirth than women aged 20 to 24.
• At least one in ten abortions world-wide occurs to women aged 15-19 years and more than 4.4 million young women in these age group have an abortion every year, 40 percent of whom are performed under unsafe conditions.
• Every day, 500,000 young people are infected with an STD most in the 20 to 24 years group, followed by those in 15 to 19 age group (UN Special Session on Children, May 2002).”

The lives of millions of adolescents worldwide are at risk because they don’t have the information, skills, health services and support they need to go through sexual development during adolescence and postpone sex until they are physically and socially mature, and able to make well-informed and responsible decisions.

The main issues in adolescence sexual and reproductive health include sexual development and sexuality including puberty, sexually transmitted diseases/HIV/AIDS and unwanted and unsafe pregnancies.

The reasons that adolescents are at risk include:

Social and economic environment - For millions of adolescents, sex is linked with coercion, violence and abuse-sometimes even by family members or adults with privileged relations. In many societies women are conditioned to be submissive to men, and they find it difficult or impossible to refuse early marriage, to space births, or to refuse to have unprotected sex with an unfaithful spouse or partner. Additionally, the social environment is critical to healthy adolescent development. There are key aspects of this environment which can prevent adolescents from engaging in unsafe / unwanted sexual behavior like strong relationship with parents, a connection to school and open communication with sexual partners.

Life and livelihood – In most countries, the great majority of adolescents are poorly informed about sexuality and reproduction. Many believe that withholding information about sexuality and reproduction from young people will dissuade them from becoming sexually active. In fact, good quality sex education does not lead to earlier or increased sexual activity among adolescents. Adolescents need life skills in order to face the challenges of adulthood. Many adolescents are victims of exploitative sex because of lack of livelihood skills and opportunities.

Access to health services – Most adolescents become sexually active before the age of 20, but generally lack access to family planning services including appropriate contraceptives, prevention and care of sexually transmitted diseases, or pregnancy care. For many young people the opening times or locations of services make them inaccessible, or the care is beyond their financial capacities. Many health care facilities require the consent of their parents or spouses or may be forbidden by law to provide services to adolescents. In addition the judgmental attitudes of many health care professionals often discourage adolescents from seeking advice and treatment related to sexual and reproductive health.

Synopsis about Reproductive Health in Ethiopia

Ethiopia is located in the eastern part of Africa neighboring the Sudan, Eritrea, Djibouti, Somalia and Kenya. It is the third largest country in Sub-Saharan Africa with a total area of 1.13 million sq km. and estimated population of 75 million 0f which 17-20 % account for urban population. Children between the age of 0 -14 years accounts for about 47 %.The total population growth rate is estimated to be 2.9 % while the birth rate is 46/1000(Country Profile).

The combination of rapid population growth and low per capita income typify the country’s extreme level of poverty. Forty-five percent of the population lives in poverty with 47 percent of the rural population and 33 percent of the urban population falling below the poverty line. The country is characterized by an expanding youth population. It is estimated that young people age 10-24 constitute more than a third of the population, about 25 million. The economic, political and social situation in Ethiopia has seriously affected this group. Access to education and health services remains limited, particularly for young rural women and men, and unemployment is a problem, particularly among young people living in urban areas. According to the Ministry of Labor and Social Affairs (MOLSA), 87% of all registered job seekers are between the ages of 15 and 29.Youth migrate from rural to urban areas looking for jobs. Young women are increasingly employed in menial jobs and may work as housemaids, cleaners, or commercial sex workers. Young men often end up as day laborers and become exposed to and engage in various types of risky behavior including unsafe sex and use of alcohol and drugs.

Ethiopian youth face a multitude of problems caused by poverty, traditional beliefs and misconceptions. As an age group, their material, social, health and reproductive needs have not been given the required attention. Government policies and programs tried to address the needs of youth along with those of the general population though youth have special needs that require different policies and program efforts.

The reproductive health problems of young people in Ethiopia are multifaceted and interrelated. Childbearing begins at early age: 45 percent of the total births in the country occur among adolescent girls and young women. Sexual violence and commercial sex work have become common phenomena among young girls. As a result, they have become primary victims of the HIV/AIDS crisis that has spread through out the country. In general, young people are at high risk of reproductive health problems aggravated by the overall poor socio economic environment and harmful traditional practices and which needs a timely and all sided interventions.

 

Project Target and Location 

Background Information about the Project Area

Oromia Regional State is located in the center of Ethiopia and is the most populous regional state with 32.3 % of the country’s population. It occupies one third of the nation area about 363,081 square kilometers. Based on the 1994 population and housing census, the projected population of the region was estimated at 23,704,000 with 2.9 % annual growth rate. Among the population, 45% are below 15 years old and economically active age group is about 50%. Out of the population 88% live in rural area and 12 % in urban areas.

Jeldu wereda is located 70 km from Addis Ababa on the main road to Ambo and 37 km from the main road on the way to Gindabarat in West Shoa Zone of Oromia Regional State. It has 4 urban Kebles and 38 rural Kebles with a total population of about 150,000. There is one health center and 6 health posts in the district.

This district is selected because: 

• It is the project areas in which HOPE 2020 is currently implementing water supply, sanitation and Hygiene project, subsequently theses kebeles are familiar for HOPE 2020 and the  implementation of the project will be facile.
• The relatively high population the district has.

Target Groups

The project mainly target on adolescents between the age 10-24 and the direct beneficiaries are about 22,500 of adolescents of the project area. The target group includes:

• Adolescent females who are not yet sexually active
• School and out of school adolescents and youths living in the project area
• Those who are married
• Unmarried sexually active adolescents
• Single mothers
• Street girls, girls who live on the street full time or par time
• Adolescents exploited through prostitution
• Genitally mutilated adolescents and those at risk of genital mutilation
• Inhabitants of the project area.

Statement of the Problem  

Ethiopia is one of the highest-ranking countries in reproductive health risk worldwide with a maternal mortality rate of 1800 per 100,000 deliveries; trained personnel attend only 6 percent of birth and 42 percent of pregnant Ethiopian women have anemia. (Country Profile HIV/AIDS-Ethiopia, Dec.2003). Besides almost in all of the countries rural areas there have no clinical services tailored for young adults in the public sector though young adulthood is a newly acknowledged life phase in many regions (Judith Senderwortz, 1997).

The prevalence of HIV/AIDS in the Oromia regional Sate including in the project area, Jeldu District, among the age groups of 15-49 yrs is 2.44% in 2005. Among the urban population the prevalence is 8.4% and 1.42% in rural areas in the same year. A total of 318,382 persons are living with HIV/AIDS in the regional state among which 33,213 are children below the age of 14 yrs. (AIDS in Ethiopia 6th Report)

According to the information from the Jeldu woreda administrative office, Most 83% of the people know about HIV/AIDS but awareness on the protection method is found rather low and HTPs is highly practiced. Awareness on RH and HIV/AIDS among the youth is not satisfactory.

Generally, the woreda’s Reproductive health issue is characterized by:

• There is great difficulty for unmarried adolescents in accessing to reproductive health services.
• Most of the adolescents are too embarrassed to attend an open family planning or reproductive health clinic and they anticipate the negative attitudes they will experience from clinic staffers.
• Teenage pregnancies and adolescent ignorance of their sexuality and their reproductive right.
• Young women who become pregnant will be shunned by their parents and forced to leave home.
• Schoolgirls who become pregnant rarely return to school whether they are married or not.
• After pregnancy women’s decisions is mostly influenced by male partners.

Negative cultural practices coupled with poverty have a devastating effect on ARH of young women of the woreda and sexually Transmitted infections (STI) are another challenge for young people in the program area. And the problems will become aggravated if further actions are not taken.

As a response to the above-mentioned problems, HOPE 2020 seeks for potential solutions as to how the problems can be minimized (if not alleviated) through creating public awareness on Gender integrated ARH and HIV/AIDS project Therefore, HOPE2020 has prepared this Community Based Reproductive Health Facility Project to be implemented in Jeldu district in west Shoa Zone of Oromia region in partnership with the communities in the area, Oromia Regional State and donor organizations.

The organization will underline the importance of fighting harmful traditional practices and ARH and HIV/AIDS awareness to achieve gender equity and improve health status of the communities.

 

Project Objectives

General Objective

The general objective of the project is to contribute in reducing adolescent sexual reproductive health problems and youth vulnerability to HIV/AIDS pandemic in the project area.

Specific Objectives

• Improve the reproductive health knowledge attitudes and skills of youth in the project area for the coming three years.
• To bring behavioral change on Adolescent sexual and reproductive health and other health related issues for the physical, mental and social well being of adolescents and youths   in the project area during the project period.
• Decrease youth vulnerability to HIV/AIDS.
• Enhance peer promotion to bring behavioral change to help youth practice the healthier behavior, including delayed sexual debut, reduced number of sexual partners and n increased use of methods for prevention pregnancy and STIS.
• To prevent and control HIV/AIDS among the rural adolescents and youths.
• Create a supportive environment for the youths in the project area
• Increase youth’s use of reproductive health services and programs.
• Increase communities particularly parents  awareness on youth sexual and reproductive rights

·     Activity Description (Activities to be carried out)   

      Recruit one project coordinator at project site (at woreda town Gojo)

• Organize six anti Aids and harmful traditional practices eradicator club organized and train 27 female and 27 male members trained on HTPs/HIV/AIDS and ARH.
• Conduct training to club leaders on reporting, planning, monitoring and record keeping.
• Conducting advocacy work with religious leaders, and community leaders to get commitment and support for the implementation of the project.
• Conduct training for religious leaders and community leaders on ARH, HTPs and HIV/AIDS using IEC/BCC approach
• Give youth Action Kit (YAK) training for 81youth peer educators issues ( with equal participation of male and female) using IEC/BCC approach
• Update societies in particular parents on the Adolescents Reproductive Health rights.
• Referral for fistula repair
• Orphan children support
• Conduct VCT and family planning training for Youths in the project area.
• Conduct seminar to health center staffs in the project area on ARH rights and issues.
• Mid term and terminal evaluation

·        

       Inputs of the Project

• Manpower – employed, invited and volunteers,
• Materials – Offices equipment, training material.
• Fund for project implementation.
• Places- office and hall room.
• Time spent by the community on workshops.      
  

·     

      Anticipated Outcomes of the Proejct

• FBO Leaders and community leaders’ awareness of ASRH, HTPs and HIV/AIDS issues will be enhanced in the project area

• Adolescent girls’ will be aware of their reproductive life and family planning
• Number of people visiting VCT centers increased in the project area
• Awareness of local community about gender, ARH and HIV/AIDS issues
• Community and religious leaders become actively involved to overcome harmful traditional practices
• Health Centers will be updated on the reproductive Health Education
• Parents awareness on adolescents sexual and reproductive rights in the project area increased
• Sexual violence in the project area decreased
• The demand for contraceptives increased by 75 % in the project area
• 9 fistula patients will get repaired
• 84 orphan children will be supported

Sustainability of the Project

To ensure sustainability, HOPE2020, is going to be partner with local stakeholders particularly women and institutional arrangement for its implementation. In this regard, HOPE2020 uses the approach “Help the communities to help themselves”; consequently Community participation, and provision of training and involvement of government and other stakeholders will be given crucial consideration.

The youth groups will be assisted to run the project by themselves by enhancing their technical and managerial skills and providing material inputs. And they will be encouraged to identify their problems by their own without waiting for external inputs as attaining success through their own effort.

HOPE 2020 tries to catalyze the process of development. Adolescents with minimal or no external assistance foster a sense of pride and self-confidence. Hence, highest involvement, commitment, and contribution of Youths towards their own development and rights will be emphasized.

 

Project Management  

There will be one project coordinator at the woreda town that is responsible to support and follow project implementation at the project site. The project coordinator at the project site will work in close collaboration with local partners and will be reporting to HOPE 2020 head office where centrally compiled report would be sent to the donor and stakeholders.

 

Project Monitoring and Evaluation  

In the course of the project implementation, the progress of activities and the overall project impact on the communities will be constantly monitored and periodically evaluated by the target communities and concerned stakeholders.

On a quarterly basis both narrative and financial reports will be prepared and submitted to all stakeholders and partner organizations.

Monitoring of activity implementation will be done regularly as part of the daily activities of the project staff at all levels of project administration with the following objectives.

•  Identifying potential project constraints and areas for an adjustment or modification
• Assessing whether resources are used effectively and efficiently, and assure timely supply of project inputs
• Ensuring that work plans are followed appropriately, and
• Continuous recording the process of qualitative change in terms of phenomena such as community participation and people’s awareness and self-confidence.

To achieve these objectives effectively, the local project partners will be actively involved in designing the process involved, analyzing the results and assessing the outcomes of the project activities so that feedback from them will guide subsequent planning and implementation of the project.

There will be a quarter meeting with the target communities to review the progress. Every quarter, progress report will be prepared and submitted to all concerned partners.

A terminal evaluation will be conducted with participation of the stakeholders to assess:

• Project impact on the community
• Achievement of project objectives
• Effectiveness of project strategies, and
• To sustainability of the project

Project Implementations Strategy and Partnerships 

The proposed project will align with the existing government structures and HOPE2020 strategic objectives. The overall strategy will be a community led response to the communities’ unconsciousness of Reproductive Health, HTPs, and   increasing Youth involvement to address their own problem and enhance self-reliance.

With the participation of Recognizing that no single organization can respond at scale that matches the existing problem, HOPE 2020 will work with local partners including government agencies, local community structures including, kebeles, the traditional funeral association, (Idir/Shengo), women Mahiber/Baltna and faith Based Organizations and civil society organizations. After the official approval of the project, HOPE 2020 will work on the detailed implementation plan including timeframe, physical and financial plan and cash flow strategies.

The traditional associations which are very much respected by the community members could be instrumental for heightening awareness on traditional and harmful practices and stimulating community decisions to overcome the problems.

 

Budget Summaries in Birr 

Budget Narratives 

• The amount of fund required for this three-years Community Based Reproductive Health Project is Birr 471,680/USD 52,408/for the project sites.
• 28% of the project fund shall be used for increasing communities’ awareness of Reproductive Health, HTPs, HIV/AIDS and family planning concepts. 
• 23% of the project fund shall be used for Youth Club formation and Peer education.
• 8% of the project fund will be used to provide school material support for 84 orphans in three years.
• 13% of the project fund shall be used for referral to 9 fistula repair in three years
• 2% of the project fund shall be used for advocacy for FBO and Community leaders to get their commitment and support of the project within three years.
• 7% of the project fund will be used to hire project coordinator at the project site.
• 6% of the project fund will be used for monitoring and evaluation.
• 3% of the project fund will be used for institutional capacity building
• 10% of the project fund will be used for administrative purposes both at head office level and at the project site for three years.
• Facilitation, coordination and logistic support will be provided by HOPE 2020.